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General NPI Number Information
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NPI Number | 1700420767
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Entity Type | Organization
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Legal Business Name | TINA FLANAGAN LICENSED MENTAL HEALTH COUNSELOR P.C.
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Dates
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Enumeration Date | 11/03/2019
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Last Update Date | 10/30/2024
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Provider Practice Location Address
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Address Line | 1777 VETERANS MEMORIAL HWY STE 14
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City | ISLANDIA
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State | NY
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Zip | 11749-1555
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Country | US
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Telephone | 631-630-6439
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Fax | 631-630-6440
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Provider Business Mailing Address
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Address Line | 4 PADDOCK LN
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City | MEDFORD
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State | NY
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Zip | 11763-4098
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Country | US
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Telephone | 631-627-4694
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | MRS. TINA FLANAGAN
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Credential | LMHC
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Telephone | 631-627-4694
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0850X
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Taxonomy Name | Adult Mental Health Clinic/Center
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License Number |
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License Number State |
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